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General NPI Number Information
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NPI Number | 1932375524
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Entity Type | Organization
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Legal Business Name | L & M MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 2100 E HALLANDALE BEACH BLVD STE 202
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-3765
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Country | US
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Telephone | 954-239-0578
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Fax | 954-239-0582
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Provider Business Mailing Address
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Address Line | 2100 E HALLANDALE BEACH BLVD STE 202
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-3765
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Country | US
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Telephone | 954-239-0578
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Fax | 954-239-0582
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Authorized Official
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Title or Position | MANAGER
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Name | CHOLPON SABYROVA
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Credential |
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Telephone | 954-239-0578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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